No abstract

In infants and children, the fingertip injuries occur frequently by accident which result causing infliction which ranges from a little cut to a fracture and also the finger amputation thus requires an immediate treatment intervention to avoid deformities. Different therapeutic approaches have been used involving surgical or conservative treatment. The conservative treatment is considered to be superior choice for management of these injuries so this research was designed to evaluate the functional and aesthetic outcomes of conservative approaches for treating fingertip injuries. Methods: This research consists of 30 children admitted to Ziaudin Hospital, Karachi with Allen's type II and III of fingertip injuries divided into three groups based on the treatment approach including Platelet Gel treatment group (group I), Fucidic acid treatment group (group II), Hyaluronic acid treatment group (group III). Results: All the conservative treatment approaches showed promising improvement regarding the range of motion, healing time, aesthetic and sensory outcome, complications, and subjective satisfaction. However, the platelet gel group exhibits significantly short healing time (p=0.003) in comparison to Fucidic acid and Hyaluronic acid treatment group Conclusion: It was concluded that conservative treatment is one of the effective approach in management of fingertip injuries in paediatric population providing better functional, sensory and aesthetic outcomes. Keywords: Fingertip injuries, Conservative treatment, Outcomes

Objective: The purpose of this research is to assess the efficacy of vascular surgery and endovascular therapy for critical limb ischemia. Study Design: Prospective study Place and Duration: This prospective study was conducted at Dow International Medical College and Dow University of Health Sciences, OJHA Campus, Karachi in the period from April, 2022 to September, 2022. Methods: Total 90 patients had critical limb ischemia were presented. All the patients were enrolled after taking informed written consent. Included patients were admitted for revascularization and divided equally in two groups. Group I received vascular surgery in 45 cases and 45 cases of group II received endovascular treatment (PTA). At 3 months post-revascularization, all patients were evaluated using the ankle-brachial index (ABI), the 6-minute walking test, and the Nottingham Health Profile (NHP) questionnaire. SPSS 22.0 was used to analyze all data. Results: The mean age of the included cases in group I was 64.6±5.57 years and in group II mean age was 69.5±8.44 years. There were majority males 33 (73.3%) in group I and 36 (80%) in group II. Comorbidities were DM, HTN, Hyperlipidemia and CAD among all cases. ABI and 6-minute walking distance improved significantly three months after the treatment in both groups. At six months post-procedure, both groups had similar NHP Part I and Part II total scores. However, the surgical revascularization group had substantially higher domain scores in social isolation and physical abilities with p value <0.012. Conclusion: Our findings indicate that patients undergoing surgical revascularization or PTA for SFA stenosis have comparable overall scores on the NHP questionnaire three months after revascularization. Subjects who undergo surgical revascularization score significantly higher than those who undergo percutaneous transluminal angioplasty (PTA) on the NHP's social isolation and physical ability dimensions. Keywords: Peripheral bypass surgery, Peripheral arterial disease, Quality of life, Endovascular treatment

Background and Aim: Hypertrophic scars are painful and can develop after surgery or trauma, with symptoms varying from an intractable allodynia to minor itch. Extraneural and intraneutral structures could be involved in painful scars issue. The standard treatment for hypertrophic scars is intralesional steroid injections. The present study aimed to investigate the lidocaine analgesia for pain relief in post-traumatic hypertrophic scars. Place and Duration: Burn Centre Dr Ruth K.M. Pfao Civil Hospital, Karachi and the department of Plastics and Burn Surgery, Bolan Medical Complex Hospital, Quetta during the period from October 2020 to September 2021. Methodology: Thirty-five patients with post-traumatic hypertrophic scars were enrolled in this study. Steroids were injected through scars with or without Lidocaine (-10°C) applications for 15 seconds. Ethical approval was taken from the institutional ethical committee. In this experimental protocol, two arms were used. In the first arm, two scars on the same patient's body were randomly assigned as control or experimental scars. Patients were used as their own controls because everyone experiences pain differently. Scars were injected into patients once a month, and pain intensity scores were recorded after each injection. A visual analog score (VAS) was used for the evaluation of pain severity or degree in each individual. Results: Of the total 35 hypertrophic scars patients, about 23 (65.7%) and 12 (34.3%) were females and male respectively. The overall mean age was 32.67±5.83 years. All the hypertrophic scars patients with age ranges from 20 to 65 years were enrolled. Of the total lesions, the presence of hypertrophic scars on the arms, shoulder, back, and chest were 7 (20%), 3 (8.6%), 9 (25.7%), and 16 (45.7%) respectively. The visual analogue score for control and pretreated was 2.8±1.42 and 7.91±1.29 respectively. The VAS pain score was significantly associated (p<0.1) with difference in VAS score of control and pretreated scars. Conclusion: The present study found that lidocaine analgesia provides significant pain relief in post-traumatic hypertrophic scars prior to steroid injection. It also provides a safe and effective way for enhancing the management of disease and patient compliance. Keywords: Hypertrophic scars, Lidocaine Analgesia, Pain relief, Steroid Injection.